Provider Demographics
NPI:1033296397
Name:VILLA ST. FRANCIS CATHOLIC CARE CENTER, INC.
Entity Type:Organization
Organization Name:VILLA ST. FRANCIS CATHOLIC CARE CENTER, INC.
Other - Org Name:VILLA ST. FRANCIS, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTHONY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-307-6840
Mailing Address - Street 1:16600 W 126TH ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1184
Mailing Address - Country:US
Mailing Address - Phone:913-826-5201
Mailing Address - Fax:913-829-5399
Practice Address - Street 1:16600 W 126TH ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1184
Practice Address - Country:US
Practice Address - Phone:913-826-5201
Practice Address - Fax:913-829-5399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSN046046314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100107450AMedicaid
KS88398OtherBCBS OF KS PROVIDER NUMBE
MO90280012OtherBCBS OF KC PROVIDER NUMBE